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1184939837
SHANE JEREMY BILLINGSLEY
WESTPORT, IN
NPI
1184939837
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
222Q00000X Developmental Therapist
Enumeration Date
2010-08-18
Last Update Date
2010-08-18
Business Address
Mr. SHANE JEREMY BILLINGSLEY DT
604 N CARROLL ST
WESTPORT, IN 47283-9787
Phone number: 812-593-5453
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Mailing Address
Mr. SHANE JEREMY BILLINGSLEY DT
604 N CARROLL ST
WESTPORT, IN 47283-9787
Phone number: 812-593-5453
Copy